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Association between vascular supply, stage and tumour size of juvenile nasopharyngeal angiofibroma
Juvenile nasopharyngeal angiofibroma (JNA) is a highly vascular tumour seen in adolescent males. To study the vascular pattern of these tumours, we retrospectively reviewed the records of patients with JNA who underwent preoperative angiography. Most (82.2 %) of the 45 patients assessed were Radkows...
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| Published in: | European archives of oto-rhino-laryngology 2016-12, Vol.273 (12), p.4295-4303 |
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| creator | Mehan, Raghav Rupa, V. Lukka, Vijay Kumar Ahmed, Munawar Moses, Vinu Shyam Kumar, N. K. |
| description | Juvenile nasopharyngeal angiofibroma (JNA) is a highly vascular tumour seen in adolescent males. To study the vascular pattern of these tumours, we retrospectively reviewed the records of patients with JNA who underwent preoperative angiography. Most (82.2 %) of the 45 patients assessed were Radkowski stage III with a mean size of 5.29 cm. There was a significant association between tumour stage and size (
p
= 0.029). Ten different vessels were seen to supply these tumours. All tumours had primary supply from the distal third of the ipsilateral internal maxillary artery (IMA). Accessory vessel supply was chiefly from the Vidian branch of internal carotid artery (ICA) (55.6 %). Stage III tumours were supplied by a greater number of feeding vessels than earlier stage tumours (
p
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| doi_str_mv | 10.1007/s00405-016-4136-9 |
| format | article |
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p
= 0.029). Ten different vessels were seen to supply these tumours. All tumours had primary supply from the distal third of the ipsilateral internal maxillary artery (IMA). Accessory vessel supply was chiefly from the Vidian branch of internal carotid artery (ICA) (55.6 %). Stage III tumours were supplied by a greater number of feeding vessels than earlier stage tumours (
p
< 0.01). Larger tumours were more likely to have ICA supply (
p
= 0.04). Bilateral supply was seen in 48.7 %. However, there was no predominance of bilateral over ipsilateral IMA supply even in advanced stage tumours. One patient in our series was found to have a caroticocavernous fistula. Residual or recurrent tumours were characterized by new vasculature (100 %) and greater accessory supply from the ipsilateral ICA (85.7 %). Our study highlights the fact that surgical planning cannot be dependent on staging alone and should include preoperative assessment of tumour vasculature by angiography.</description><identifier>ISSN: 0937-4477</identifier><identifier>EISSN: 1434-4726</identifier><identifier>DOI: 10.1007/s00405-016-4136-9</identifier><identifier>PMID: 27289235</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescent ; Adult ; Angiofibroma - blood supply ; Angiofibroma - diagnostic imaging ; Angiofibroma - pathology ; Angiography ; Carotid Artery, Internal - diagnostic imaging ; Child ; Female ; Head and Neck Surgery ; Humans ; Male ; Maxillary Artery - diagnostic imaging ; Medicine ; Medicine & Public Health ; Nasopharyngeal Neoplasms - blood supply ; Nasopharyngeal Neoplasms - diagnostic imaging ; Nasopharyngeal Neoplasms - pathology ; Neoplasm Staging ; Neurosurgery ; Ophthalmic Artery ; Otorhinolaryngology ; Retrospective Studies ; Rhinology ; Time Factors ; Tumor Burden</subject><ispartof>European archives of oto-rhino-laryngology, 2016-12, Vol.273 (12), p.4295-4303</ispartof><rights>Springer-Verlag Berlin Heidelberg 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c344t-1fc9e20be28c477d807f75a65e1d2a0b83930bacc012b54748c43a0400017a593</citedby><cites>FETCH-LOGICAL-c344t-1fc9e20be28c477d807f75a65e1d2a0b83930bacc012b54748c43a0400017a593</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27289235$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mehan, Raghav</creatorcontrib><creatorcontrib>Rupa, V.</creatorcontrib><creatorcontrib>Lukka, Vijay Kumar</creatorcontrib><creatorcontrib>Ahmed, Munawar</creatorcontrib><creatorcontrib>Moses, Vinu</creatorcontrib><creatorcontrib>Shyam Kumar, N. K.</creatorcontrib><title>Association between vascular supply, stage and tumour size of juvenile nasopharyngeal angiofibroma</title><title>European archives of oto-rhino-laryngology</title><addtitle>Eur Arch Otorhinolaryngol</addtitle><addtitle>Eur Arch Otorhinolaryngol</addtitle><description>Juvenile nasopharyngeal angiofibroma (JNA) is a highly vascular tumour seen in adolescent males. To study the vascular pattern of these tumours, we retrospectively reviewed the records of patients with JNA who underwent preoperative angiography. Most (82.2 %) of the 45 patients assessed were Radkowski stage III with a mean size of 5.29 cm. There was a significant association between tumour stage and size (
p
= 0.029). Ten different vessels were seen to supply these tumours. All tumours had primary supply from the distal third of the ipsilateral internal maxillary artery (IMA). Accessory vessel supply was chiefly from the Vidian branch of internal carotid artery (ICA) (55.6 %). Stage III tumours were supplied by a greater number of feeding vessels than earlier stage tumours (
p
< 0.01). Larger tumours were more likely to have ICA supply (
p
= 0.04). Bilateral supply was seen in 48.7 %. However, there was no predominance of bilateral over ipsilateral IMA supply even in advanced stage tumours. One patient in our series was found to have a caroticocavernous fistula. Residual or recurrent tumours were characterized by new vasculature (100 %) and greater accessory supply from the ipsilateral ICA (85.7 %). Our study highlights the fact that surgical planning cannot be dependent on staging alone and should include preoperative assessment of tumour vasculature by angiography.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Angiofibroma - blood supply</subject><subject>Angiofibroma - diagnostic imaging</subject><subject>Angiofibroma - pathology</subject><subject>Angiography</subject><subject>Carotid Artery, Internal - diagnostic imaging</subject><subject>Child</subject><subject>Female</subject><subject>Head and Neck Surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Maxillary Artery - diagnostic imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nasopharyngeal Neoplasms - blood supply</subject><subject>Nasopharyngeal Neoplasms - diagnostic imaging</subject><subject>Nasopharyngeal Neoplasms - pathology</subject><subject>Neoplasm Staging</subject><subject>Neurosurgery</subject><subject>Ophthalmic Artery</subject><subject>Otorhinolaryngology</subject><subject>Retrospective Studies</subject><subject>Rhinology</subject><subject>Time Factors</subject><subject>Tumor Burden</subject><issn>0937-4477</issn><issn>1434-4726</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNp9kD1PwzAQhi0EoqXwA1iQRwYC54_EyVghvqRKLDBbjnMpqZI4xElR-fW4SmFkuuF97tXdQ8glg1sGoO48gIQ4ApZEkokkyo7InEkhI6l4ckzmkAkVSanUjJx5vwGAWGbilMy44mnGRTwn-dJ7ZyszVK6lOQ5fiC3dGm_H2vTUj11X726oH8waqWkLOoyNG0NQfSN1Jd2MW2yrGmlrvOs-TL9r12jqgK4rV1Z57xpzTk5KU3u8OMwFeX98eLt_jlavTy_3y1VkhZRDxEqbIYcceWrDyUUKqlSxSWJkBTeQpyITkBtrgfE8lkoGTJggAIApE2diQa6n3q53nyP6QTeVt1jXpkU3es1SnihIkjgJKJtQ2zvveyx111dNuF4z0Hu1elKrg1q9V6v39VeH-jFvsPjb-HUZAD4BPkRBQ683QVUbXv6n9Qd7yYUE</recordid><startdate>20161201</startdate><enddate>20161201</enddate><creator>Mehan, Raghav</creator><creator>Rupa, V.</creator><creator>Lukka, Vijay Kumar</creator><creator>Ahmed, Munawar</creator><creator>Moses, Vinu</creator><creator>Shyam Kumar, N. K.</creator><general>Springer Berlin Heidelberg</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20161201</creationdate><title>Association between vascular supply, stage and tumour size of juvenile nasopharyngeal angiofibroma</title><author>Mehan, Raghav ; Rupa, V. ; Lukka, Vijay Kumar ; Ahmed, Munawar ; Moses, Vinu ; Shyam Kumar, N. 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K.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European archives of oto-rhino-laryngology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mehan, Raghav</au><au>Rupa, V.</au><au>Lukka, Vijay Kumar</au><au>Ahmed, Munawar</au><au>Moses, Vinu</au><au>Shyam Kumar, N. K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association between vascular supply, stage and tumour size of juvenile nasopharyngeal angiofibroma</atitle><jtitle>European archives of oto-rhino-laryngology</jtitle><stitle>Eur Arch Otorhinolaryngol</stitle><addtitle>Eur Arch Otorhinolaryngol</addtitle><date>2016-12-01</date><risdate>2016</risdate><volume>273</volume><issue>12</issue><spage>4295</spage><epage>4303</epage><pages>4295-4303</pages><issn>0937-4477</issn><eissn>1434-4726</eissn><abstract>Juvenile nasopharyngeal angiofibroma (JNA) is a highly vascular tumour seen in adolescent males. To study the vascular pattern of these tumours, we retrospectively reviewed the records of patients with JNA who underwent preoperative angiography. Most (82.2 %) of the 45 patients assessed were Radkowski stage III with a mean size of 5.29 cm. There was a significant association between tumour stage and size (
p
= 0.029). Ten different vessels were seen to supply these tumours. All tumours had primary supply from the distal third of the ipsilateral internal maxillary artery (IMA). Accessory vessel supply was chiefly from the Vidian branch of internal carotid artery (ICA) (55.6 %). Stage III tumours were supplied by a greater number of feeding vessels than earlier stage tumours (
p
< 0.01). Larger tumours were more likely to have ICA supply (
p
= 0.04). Bilateral supply was seen in 48.7 %. However, there was no predominance of bilateral over ipsilateral IMA supply even in advanced stage tumours. One patient in our series was found to have a caroticocavernous fistula. Residual or recurrent tumours were characterized by new vasculature (100 %) and greater accessory supply from the ipsilateral ICA (85.7 %). Our study highlights the fact that surgical planning cannot be dependent on staging alone and should include preoperative assessment of tumour vasculature by angiography.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>27289235</pmid><doi>10.1007/s00405-016-4136-9</doi><tpages>9</tpages></addata></record> |
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| subjects | Adolescent Adult Angiofibroma - blood supply Angiofibroma - diagnostic imaging Angiofibroma - pathology Angiography Carotid Artery, Internal - diagnostic imaging Child Female Head and Neck Surgery Humans Male Maxillary Artery - diagnostic imaging Medicine Medicine & Public Health Nasopharyngeal Neoplasms - blood supply Nasopharyngeal Neoplasms - diagnostic imaging Nasopharyngeal Neoplasms - pathology Neoplasm Staging Neurosurgery Ophthalmic Artery Otorhinolaryngology Retrospective Studies Rhinology Time Factors Tumor Burden |
| title | Association between vascular supply, stage and tumour size of juvenile nasopharyngeal angiofibroma |
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